Citation NR: 9717647
Decision Date: 05/20/97 Archive Date: 05/29/97
DOCKET NO. 91-38 160 ) DATE
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On appeal from the
Department of Veterans Affairs (VA) Regional Office (RO)
in Albuquerque, New Mexico
THE ISSUES
1. Entitlement to service connection for hearing loss.
2. Entitlement to service connection for tinnitus.
REPRESENTATION
Appellant represented by: Military Order of the Purple
Heart
ATTORNEY FOR THE BOARD
S.R. Horn, Associate Counsel
INTRODUCTION
The veteran served on active duty from August 1965 to August
1968.
This matter comes to the Board of Veterans’ Appeals (Board)
on appeal from a December 1990 decision by the VA RO in
Albuquerque, New Mexico, which denied an application to
reopen a previously denied claim for service connection for
hearing loss and denied service connection for tinnitus. In
1991, the Board remanded the case to the RO for a current
audiometric examination, as well as for evidentiary
development regarding a claim for service connection for
post-traumatic stress disorder (PTSD). In 1993, the Board
again remanded the case, this time only regarding the PTSD
claim. In October 1995, the RO granted service connection
for PTSD, and that matter is no longer on appeal. In this
decision, the RO also reopened and denied the claim for
service connection for hearing loss. Thus, the current
claims before the Board are entitlement to service connection
for hearing loss and tinnitus.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends his current hearing loss and tinnitus
were caused by acoustic trauma in service. Specifically, he
asserts that exposure to loud noise from weaponry fire and
aircraft when he was a helicopter crew chief in service
caused the hearing loss and tinnitus, and that he has
suffered from these conditions ever since.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991 & Supp. 1996), has reviewed and considered
all of the evidence and material of record in the veteran's
claims file. Based on its review of the relevant evidence in
this matter, and for the following reasons and bases, it is
the decision of the Board that service connection for
bilateral hearing loss and tinnitus is warranted.
FINDING OF FACT
The veteran’s current bilateral hearing loss and associated
tinnitus originated during service.
CONCLUSION OF LAW
Bilateral hearing loss and tinnitus were incurred in service.
38 U.S.C.A. § 1110, (West 1991 & Supp. 1996); 38 C.F.R.
§ 3.303 (1996).
REASONS AND BASES FOR FINDING AND CONCLUSION
I. Factual Background
The veteran served on active duty in the Army from August
1965 to August 1968, including service in Vietnam. His
service personnel records show his military occupational
specialty was a helicopter repair mechanic. They show he was
awarded the Air Medal with the First through Thirty-third Oak
Leaf Cluster and a citation for meritorious achievement in
aerial flight in support of combat ground forces. His
service medical records note he served as a crew chief and as
an assistant gunner on a rocket launcher range.
The service medical records include an August 1965 service
enlistment examination showing his ears were normal. This
examination also included audiometric testing revealing pure
tone decibel thresholds were recorded at 500, 1,000, 2,000,
3,000, 4,000, and 6,000 hertz as 25, 20, 10, 5, -5, and 0,
respectively, in the right ear; and 30, 20, 10, 10, 15, and
0, respectively, in the left ear (converted to current
standards). On an accompanying medical history form, the
veteran marked “no” for a history of ear problems or the
wearing of hearing aids. He was assigned a physical profile
(PULHES) for hearing of H-1 (1 being normal). A February
1966 physical examination shows the ears were normal, and
audiometric testing revealed pure tone decibel thresholds
(converted to current standards) at 500, 1,000, 2,000, 3,000,
4,000, and 6,000 hertz as 30, 5, 5, 15, 10, and 15,
respectively, in the right ear; and 10, 5, 0, 25, 60, and 55,
respectively, in the left ear. A December 1967 physical
examination showed the ears were normal, and on an
accompanying medical history form, the veteran marked “no”
for a history of hearing loss. The remainder of the service
medical records are negative for any hearing loss and
tinnitus, and the veteran’s physical profile for hearing
remained an H-1 throughout service. The August 1968
separation examination shows the ears were normal. The
examination included audiometric testing that revealed pure
tone decibel thresholds were recorded at 500, 1,000, 2,000,
and 4,000 hertz as 5, 30, 50, and 70, respectively, in the
right ear; and 5, 20, 20, and 80, respectively, in the left
ear. The examination also included another audiometric test,
which was labeled “repeat audio,” and which recorded pure
tone decibel thresholds at 500, 1,000, 2,000, 4,000, and
8,000 hertz as -10, -10, -5, 10, and 20, respectively, in the
right ear; and 5, -5, -5, -10, and -5, respectively, in the
left ear. The diagnosis of marked bilateral hearing loss was
crossed out, and the physical profile for hearing was H-1.
On an accompanying medical history form, the veteran gave a
history of hearing loss.
In January 1971, the veteran underwent a VA general medical
examination. He made no complaints of hearing loss.
Objective findings were that the ears were normal and that
there was no hearing loss on clinical evaluation (audiometric
testing was not performed).
VA medical records from November 1990 show the veteran
complained of long-standing bilateral constant tinnitus and
decreased hearing for certain sounds such as telephone and
doorbell ringing. He gave a history of the onset of these
symptoms during service when he was a helicopter crew chief.
He also gave a history of familial deafness (his father) and
noise exposure. Audiometric testing revealed that pure tone
decibel thresholds were recorded at 250, 500, 1,000, 2,000,
3,000, 4,000, and 8,000 hertz as 10, 15, 5, 0, 25, 70, and
55, respectively, in the right ear; and 5, 5, 5, 10, 55, 80,
and 60, respectively, in the left ear. Speech discrimination
was 100 percent correct in both ears. The diagnosis was
bilateral high frequency sensorineural hearing loss with
persistent tinnitus, most likely due to noise exposure. The
examiner commented the veteran was a candidate for hearing
aid use, was counseled in hearing preservation, and advised
to undergo periodic reevaluation.
The veteran underwent a VA audiometric examination in April
1992. Pure tone decibel thresholds were recorded at 1,000,
2,000, 3,000, and 4,000 hertz as 5, 5, 20, and 70,
respectively, in the right ear; and 5, 10, 55, and 80,
respectively, in the left ear. Speech discrimination was 100
percent correct in the right ear, and 92 percent correct in
the left ear. The diagnosis was bilateral high frequency
hearing loss. The examiner noted the veteran reported
constant bilateral tinnitus which was consistent with his
loss of hearing and history of acoustic trauma.
In an August 1992 statement, the veteran reported he was not
surprised that the hearing in his left ear was worse than in
his right ear because, as a helicopter crew chief for 7
months in service, he sat on the left side of an aircraft
with a minigun firing 2,500 to 3,000 rounds per minute about
5 feet from his left ear. He also said he had enjoyed
hunting prior to service, suffered headaches when he went
hunting after service, and was no longer able to hunt.
II. Analysis
The veteran’s claim for service connection for hearing loss
is well grounded, meaning not inherently implausible. All
relevant facts have been properly developed and, therefore,
the VA’s duty to assist the veteran has been satisfied.
38 U.S.C.A. § 5107(a).
Service connection may be granted for a disability resulting
from a disease or injury incurred in or aggravated by
service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303. Certain
chronic diseases, including sensorineural hearing loss, which
become manifest to a compensable degree within the year after
service, will be rebuttably presumed to have been incurred in
service. 38 U.S.C.A. §§ 1101, 1112, 1113; 38 C.F.R.
§§ 3.307, 3.309.
Impaired hearing is considered a disability for VA benefits
purposes when the auditory threshold in any of the
frequencies 500, 1,000, 2,000, 3,000, and 4,000 hertz is 40
dB or greater, or where the auditory thresholds for at least
three of the frequencies 500, 1,000, 2,000, 3,000, or 4,000
hertz are 26 dB or greater, or when speech recognition scores
using the Maryland CNC Test are less than 94 percent.
38 C.F.R. § 3.385.
The veteran’s service records show he served as a helicopter
crew chief and had combat duty in service. He has submitted
written statements that he was exposed to loud noise from
weaponry fire and aircraft in that capacity in service, and
the Board accepts these statements as evidence of such
exposure. The service medical records show the veteran had
left ear hearing loss in the higher frequencies at a February
1966 audiometric test, but no diagnosis of hearing loss or
tinnitus was made. The August 1968 separation examination
included two audiometric tests, the first showing bilateral
hearing loss in the higher frequencies and the second, a
“repeat audio,” showing the veteran’s hearing was normal.
The examination shows the veteran had been diagnosed as
having bilateral hearing loss, and that the diagnosis was
crossed out. The service medical records are negative for
any complaints, findings, or diagnoses of tinnitus.
A VA examination in January 1971, more than two years after
service, shows the veteran did not complain of any hearing
loss or tinnitus, had normal ears, and was not noted to have
hearing loss or tinnitus on clinical evaluation, although
audiometric testing was not performed The next indication of
any hearing loss or tinnitus is not until 1990, many years
after service, when the veteran was diagnosed as having
bilateral high frequency hearing loss with persistent
tinnitus at a VA audiometric examination. The VA medical
records from 1990 show the veteran gave a history of hearing
loss and tinnitus since service, and show he was diagnosed as
having bilateral high frequency sensorineural hearing loss
with persistent tinnitus, most likely due to noise exposure.
The 1992 VA audiometric examination shows he was diagnosed as
having bilateral high frequency hearing loss, and shows he
reported constant bilateral tinnitus which the examiner
commented was consistent with his loss of hearing and history
of acoustic trauma.
The Board notes there is substantial evidence against service
connection for hearing loss and tinnitus. Such includes the
normal findings on the repeat audiometric test at the 1968
service separation examination, the absence of clinical
findings of hearing loss at the 1971 VA examination, and the
lengthy time period after service (until 1990) without
medical documentation of the conditions.
However, there is also evidence in favor of service
connection. During service the veteran was exposed to loud
noise. Service medical records do include some findings of
hearing loss, including at the initial audiometric test for
service separation in 1968 which led to a diagnosis (later
crossed out) of marked bilateral hearing loss. The veteran
also gave a history of hearing loss at the time of the
separation examination. As between the abnormal audiometric
test at service separation, and the repeat normal test, there
is at least a possibility that the initial test had some
validity. The 1971 VA examination lacked audiometric testing
which may have disclosed hearing loss. The 1990 and 1992 VA
medical records appear to associate the veteran’s current
bilateral hearing loss with acoustic trauma in service, and
also appear to link current tinnitus with the hearing loss.
Although there is no medical evidence of tinnitus until long
after service, it is known that such condition may be
associated with sensorineural hearing loss.
After comparing the evidence for and against the claims, the
Board finds that it is approximately balanced for and against
service connection, and under such circumstances the veteran
is given the benefit of the doubt. 38 U.S.C.A. § 5107(b).
Thus, the Board finds that the veteran’s bilateral hearing
loss and tinnitus originated in service. The conditions were
incurred in service and service connection is warranted.
ORDER
Service connection for bilateral hearing loss and tinnitus is
granted.
L.W. TOBIN
Member, Board of Veterans' Appeals
38 U.S.C.A. § 7102 (West Supp. 1996) permits a proceeding
instituted before the Board to be assigned to an individual
member of the Board for a determination. This proceeding has
been assigned to an individual member of the Board.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991 & Supp. 1996), a decision of the Board of Veterans'
Appeals granting less than the complete benefit, or benefits,
sought on appeal is appealable to the United States Court of
Veterans Appeals within 120 days from the date of mailing of
notice of the decision, provided that a Notice of
Disagreement concerning an issue which was before the Board
was filed with the agency of original jurisdiction on or
after November 18, 1988. Veterans' Judicial Review Act,
Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The
date which appears on the face of this decision constitutes
the date of mailing and the copy of this decision which you
have received is your notice of the action taken on your
appeal by the Board of Veterans' Appeals.
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